BMC Nephrol. 2014 Mar 19;15(1):47. doi: 10.1186/1471-2369-15-47.
Parikh A, Chase HS, Vernocchi L, Stern L1.
Previous studies have shown that treatment with ergocalciferol in patients with CKD stage 3 + 4 is not effective with less than 33% of patients achieving a 25-OH vitamin D target of >30 ng/ml. The aim of this study was to test the response to cholecalciferol in CKD. We attempted to replete 25-OH vitamin D to a target level of 40-60 ng/ml using the response to treatment and PTH suppression as an outcome measure.
This retrospective cohort study identified patients (Stages 2-5 and Transplant) from 2001-2010 who registered at the Chronic Kidney Disease Clinic. Patients received cholecalciferol 10,000 IU capsules weekly as initial therapy. When levels above 40 ng/ml were not achieved, doses were titrated up to a maximum of 50,000 IU weekly. Active vitamin D analogs were also used in some Stage 4-5 CKD patients per practice guidelines. Patients reaching at least one level of 40 ng/mL were designated RESPONDER, and if no level above 40 ng/mL they were designated NON-RESPONDER. Patients were followed for at least 6 months and up to 5 years.
RESULTS: 352 patients were included with a mean follow up of 2.4 years. Of the CKD patients, the initial 25-OH vitamin D in the NON-RESPONDER group was lower than the RESPONDER group (18 vs. 23 ng/ml) (p = 0.03). Among all patients, the initial eGFR in the RESPONDER group was significantly higher than the NON-RESPONDER group (36 vs. 30 ml/min/1.73 m2) (p < 0.001). Over time, the eGFR of the RESPONDER group stabilized or increased (p < 0.001). Over time, the eGFR in the NON-RESPONDER group decreased toward a trajectory of ESRD. Proteinuria did not impact the response to 25-OH vitamin D replacement therapy. There were no identifiable variables associated with the response or lack of response to cholecalciferol treatment.
CONCLUSIONS: CKD patients treated with cholecalciferol experience treatment resistance in raising vitamin D levels to a pre-selected target level. The mechanism of vitamin D resistance remains unknown and is associated with progressive loss of eGFR. Proteinuria modifies but does not account for the vitamin D resistance.
PDF is attached at the bottom of this page
- Overview Kidney and vitamin D
- Kidney failure – still debating what form of vitamin D to use – April 2016
- Time-release form of active vitamin D granted a patent for chronic kidney disease – July 2014
- 4X more Chronic Kidney disease patients are now using vitamin D – March 2014
- Kidney Inflammation: both prevented and reduced by Vitamin D – review Jan 2014
- Calcitriol category listing has
46 items along with related searches
- Getting Vitamin D into your body has the following graphic
The TOP articles in Kidney and Vitamin D are listed here:
Chronic Kidney Disease study not aware of appropriate forms of vitamin D – March 2014
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
- Inflammatory diseases: review of vitamin D, with many tables – May 2014
- Vitamin D level can be high, but little benefit: due to kidney, genes, low Magnesium etc.
- Omega 3 increased by 60 percent the ACTIVE vitamin D in the blood – Aug 2012
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
4191 visitors, last modified 28 Apr, 2016,